| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $3,822.60 | $21,373.30 | $21,373.30 | |
Cigna
| Facility | $4,819.80 | $6,481.80 | $9,822.42 | |
Cigna
| Professional | $3,819.42 | $4,819.80 | $4,819.80 | |
Providence
| Facility | $4,819.80 | $6,481.80 | $9,822.42 | |
Providence
| Professional | $2,991.60 | $3,324.00 | $4,819.80 | |
United
| Professional | $1,396.08 | $1,396.08 | $3,324.00 |